论文部分内容阅读
患者,男,24岁,因呕血、黑便4天入院.患者1岁时发现肝脾肿大,当时诊断为迁延性肝炎、脾功能亢进.患者姐姐及一兄分别于8岁和12岁时死于“肝硬化并发上消化道出血”,另一兄健在.父母非近亲结婚,其母生第一胎时曾患“急性肝炎”.体检:BP12/8kPa,HR108次/min,发育正常,重度贫血貌,巩膜无黄染,未见肝掌蜘蛛痣,浅表淋巴结未及肿大,头面部无畸形,心肺正常,腹平软,无腹壁静脉显露,肝肋下3cm,脾肋下7cm,质地中等,无触痛,腹部移动性浊音(-),肾区无叩痛,脊柱四肢无畸形.辅助检查:Hb70g/L,,白细胞、血小板及尿常规正常,HBsAg(-),A/G=34/25,AFP<20μg/L,肝功及凝血酶原时间正常,血铜及铜蓝蛋白正常,溶血检查(-),骨髓象示缺铁性贫血.胃镜检查诊断
Patients, male, 24 years old, due to hematemesis, melena 4 days admission .At 1 year old found hepatosplenomegaly, was diagnosed with persistent hepatitis, hypersplenism .Patients sister and a brother, respectively, at the age of 8 and 12 Died of “cirrhosis of the upper gastrointestinal bleeding,” another brother alive in. Parents of non-relatives get married, their first child had a mother had “acute hepatitis.” Physical examination: BP12 / 8kPa, HR108 times / min, normal development, Severe anemia, sclera no yellow dye, no palmate liver palms, superficial lymph nodes without swelling, head and face deformity, normal heart and lungs, abdominal soft, no abdominal veins revealed, ribs under the ribs 3cm, Spleen rib 7cm , Moderate texture, no tenderness, dullness of abdominal movement (-), no percussion pain in the kidney area and no deformity of the spine and limbs.Auxiliary examination: Hb70g / L, normal white blood cells, platelets and urine, HBsAg (-), A / G = 34/25, AFP <20μg / L, normal liver function and prothrombin time, normal blood copper and ceruloplasmin, hemolytic examination (-), bone marrow showed iron deficiency anemia.